Provider Demographics
NPI:1013279751
Name:APPLEGATE, DANIEL JOSEPH
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:APPLEGATE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 FOOTHILLS BLVD
Mailing Address - Street 2:SUITE 146
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-7241
Mailing Address - Country:US
Mailing Address - Phone:916-751-9800
Mailing Address - Fax:
Practice Address - Street 1:4010 FOOTHILLS BLVD
Practice Address - Street 2:SUITE 146
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-7241
Practice Address - Country:US
Practice Address - Phone:916-751-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA043045347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle